European Registry Update Georgios Sianos, MD, PhD, FESC Aristotle University, AHEPA University Hospital Thessaloniki, Greece

Disclosure Statement of Financial Interest I, Georgios Sianos, DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation. All CTO 2015 faculty disclosures are listed on the CRF Events App.

Euro CTO Club Membership

Web based ERCTO Registry

Online Registry 2008-2014

Antegrade /Retrograde Operators N=24 N=29 N=35 N=44 N=48 N=48 N=42

Antegrade /Retrograde Procedures

Angiographic Success %

Angiographic Success %

Procedural Success by JCTO Score according to Experience in Retrograde % Low = <50 procedure retrograde Moderate = 50-100 retrograde Good = >100 retrograde

Multivariate logistic regression analysis associated with technical failure in retrograde approach Variable OR 95% CI p-value Age, per 10-yr increase 1.19 1.04-1.36 0.01 Men 0.70 0.47-1.05 0.08 Diabetes 1.16 0.86-1.55 0.33 Ejection fraction <35% 0.89 0.50-1.58 0.68 History of MI, % 0.91 0.68-1.21 0.50 History of CABG, % 1.22 0.86-1.74 0.26 Prior PCI, % 0.98 0.74-1.29 0.87 Occlusion duration <12 months 0.95 0.80-1.12 0.55 Occlusion length < 20 mm 1.00 0.62-1.64 0.99 Operator Experience <50 versus >100 50-100 versus >100 3.07 2.17 2.19-4.30 1.52-3.10 <0.0001 J-CTO Score Intermediate versus very difficult Medium difficult versus very difficult Quite difficult versus very difficult 0.44 0.42 0.61 0.25-0.77 0.28-0.62 0.44-0.85

Wires to start %

Wires to start (Fielder XT Family) %

Final wires %

Guiding Catheter Selection in the ERCTO % 53,8 49,8 49,8 48,5 48,3 45,8 43,5 40,9 37,8 35,4 15,6 10,9 8,7 7,4 7,9 2010 2011 2012 2013 2014 6 French 7 French 8 French No trend differences were observed between antegrade and retrograde approach during years

Procedural Details % Controlateral injection Radial approach 2010 2011 61,6 54,4 53,7 49,4 47,2 17,5 15,7 15 12,2 8,6 2010 2011 2012 2013 2014 Controlateral injection Radial approach

Use of Dedicated Devices %

IVUS %

Procedural Complications Death Cardiac tamponade Myocardial infarction Vascular complication Coronary perforation Donor vessel dissection

Credibility check of the online EuroCTO-registry 2008-14 Logical checks on data ( predefined value ranges) Logical consistency-tests with respect to other data fields Automatic warnings when data are missing Courtesy C Reifart

2015 and on 10 % reabstraction of CTO records (n = 250/ year), masked and reviewed by a second abstractor

At random : „ your patient was selected for monitoring“ Automatic export of registry parameters 9 parameters to be checked by reviewer

CD will automatically be uploaded (Videoloader) It automatically stores all files to prepare Operator

At least 4 cineruns to be uploaded CTO vessel with retrograde/antegrade distal filling; Wire passage If applicable also for retrograde access Final result showing residual lesion and runoff.

Add requested runs to file

Any run can be played at high resolution and be reviewed

1 2 3 4 7 5/ 6

8 9

Monitor The monitor will evaluate the case in a structured way that finally  results in an agreement agreement with slight differences or relevant disagreement (i.e. no CTO or no TIMI 3 flow)

Test: Operator NR Monitor GW

Calculated accordance 84 %

Summary: ERCTO-Monitoring Randomly selects 10% of cases Non biased controll of data entry Will indentify: errors of data entry, interpretation or coding and errors of intention Will increase credibility and scientific value